As simultaneously converging crises threaten to compound inequalities and with growing attention on the need to address the unmet medical needs of women, the EU must step up its efforts to support global women’s health R&D, six MEPs write.
ADVERTISEMENTWomen bear the brunt of health crises. COVID-19 laid bare the stark inequalities that women face.
Personal protective equipment (PPE) does not fit female bodies properly as they are designed for male bodies (despite women accounting for over 70% of the world’s healthcare providers).
The lack of inclusion of pregnant people in vaccine trials drove vaccine hesitancy with alarming consequences. Lockdowns increased the risk of gender-based violence — as highlighted in the lessons learnt report that the European Parliament’s COVI special committee put forward in 2023.
As members of the newly established women’s health interest group in the European Parliament, the persisting failure to consider the health needs of women, in all their diversity is an issue that is high on our agenda.
This exclusion extends to the earliest stages of research, with biomedical research experiments rarely using or reporting the differences between male and female sex cells.
Such "blindness" to sex and gender differences continues across the research and development (R&D) pipeline, resulting in the development of health technologies that are not always effective or safe for women — they are twice as likely to experience an adverse drug reaction compared to men.
Increasing threats, disproportionate risks
As the world faces increasing health threats, women face a heightened risk. Biological factors and gender norms lead to disparities in disease severity and socioeconomic consequences. In its recently updated global health strategy, the EU "prioritised tackling the root causes of ill health, paying particular attention to the rights of women and girls, vulnerable populations and disadvantaged groups".
This must underpin the strategy’s commitment to "ensure that innovative vaccines, treatments, and diagnostics for new, prevalent, or neglected infectious and non-communicable diseases, are developed and used, including through funding from Horizon Europe."
The EU should make available dedicated funding to specifically address the knowledge and product gaps that persist for women and girls, including support for interdisciplinary research projects that address the complex interplay between health, gender, and the environment.
Women in low- and middle-income countries (LMICs) are particularly vulnerable to infectious diseases due to geographic, socio-economic, and political factors that increase exposure and limit access to prevention and treatment.
In sub-Saharan Africa, adolescent girls and young women are more than three times as likely to acquire HIV than their male peers. They also face high rates of malaria, which can pose severe complications during pregnancy — it's estimated to have caused 819,000 low-birthweight babies in the region in 2020.
Infectious diseases are deeply intertwined with women’s sexual and reproductive health, and climate change threatens to exacerbate the severity of these joint challenges, from vector-borne diseases such as dengue spreading as a result of a changing climate to disruption in access to sexual and reproductive health services as a result of extreme weather events.
Rebalancing the global research agenda
A fairer distribution of research funding that better reflects disease burden and women’s unmet needs would help to account for gender-related barriers, vulnerabilities and opportunities, better prioritising R&D investments towards the areas in which women are most in need.
The EU’s strong international collaboration on R&I offers ample opportunity to deliver progress on this agenda in collaboration with international organisations, research institutions, the private sector, civil society representatives, and, importantly, affected communities.
Analysis of research trends demonstrates that the funding for diseases that disproportionately impact women — including endometriosis, gynaecological cancers, migraine and anxiety disorder — is not aligned with the burden of disease.
This disparity is even starker for conditions that continue to disproportionately impact women in developing countries.
A recent publication highlights that maternal health conditions such as preeclampsia/ eclampsia and postpartum haemorrhage received less than 1% of European sexual & reproductive health R&D funding between 2018 and 2020.
Untapped potential to address unmet needs
Making sex and gender considerations a requirement for receiving research funding from the EU’s flagship research framework programme Horizon Europe certainly signified a considerable commitment from the EU to driving gender equality in R&D.
ADVERTISEMENTIt will be crucial that such efforts are strengthened in its successor (FP10), with a need for greater focus on intersectional considerations (such as the intersection of gender with age, race, and socio-economic status) and more rigorous investigation into women’s unmet health needs through dedicated funding.
Europe accounts for only 13% of the global funding for sexual and reproductive health R&D, with investments split evenly between public and private organisations. More of the EU’s health and research budgets should be allocated to women's health — not just for female-specific conditions but to better understand and deliver interventions for conditions that disproportionately, differently, or uniquely impact women.
Innovative funding models should also be explored to better align public and private investment to deliver innovations with the greatest promise of better health for women.
It is no longer acceptable that in 2024, women experience daily the direct impact of gender inequity in healthcare, barriers to and delays in accessing preventive services and healthcare, being dismissed by health professionals and receiving inaccurate diagnoses and suboptimal treatments.
From medical education that breaks down the biases that persist to inclusion of sex and gender in research to improved pharmacovigilance activities — we must accelerate efforts to reverse this inequity.
ADVERTISEMENTAs simultaneously converging crises threaten to compound inequalities and with growing attention on the need to address the unmet medical needs of women, the EU must step up its efforts to support global women’s health R&D.
In delivering better health outcomes for women, such investments will contribute to improved societal wellbeing, for the benefit of us all.
Tilly Metz (Greens/EFA, Luxembourg), Frances Fitzgerald (EPP, Ireland), Deirdre Clune (EPP, Ireland), Sirpa Pietikäinen (EPP, Finland), Radka Maxová (S&D, Czechia), Barry Andrews (Renew, Ireland) are Members of the European Parliament.
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